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The management of pregnancy in paroxysmal nocturnal haemoglobinuria on long term eculizumab |
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| Authors: | Richard Kelly Louise Arnold Stephen Richards Anita Hill Charlotte Bomken John Hanley Andrew Loughney Jon Beauchamp Gus Khursigara Russell P. Rother Elizabeth Chalmers Andrew Fyfe Edward Fitzsimons Ryotaro Nakamura Anna Gaya Antonio M. Risitano Jörg Schubert Derek Norfolk Nigel Simpson Peter Hillmen |
| Affiliation: | 1. Institute of Oncology, St James’s University Hospital, Leeds;2. Department of Haematology, Bradford Royal Infirmary, Bradford;3. Department of Haematology Royal Victoria Infirmary;4. Department of Obstetrics, Royal Victoria Infirmary, Newcastle‐Upon‐Tyne;5. Alexion Pharmaceuticals Inc, Guilford, UK;6. Alexion Pharmaceuticals Inc, Cheshire, CT, USA;7. Department of Haematology,Queen Mothers Hospital, Glasgow;8. Department of Haematology, Gartnavel General Hospital, Glasgow, UK;9. Division of Hematology & Bone Marrow Transplant, City of Hope National Medical Center & Beckman Research Institute, Duarte, CA, USA;10. Department of Hematology, Hospital Clínic, University of Barcelona, Villarroel 170, Barcelona, Spain;11. Departmant of Biochemistry and Medical Biotechnologies, Federico II University, Naples, Italy;12. Saarland Univ. Med. School, Homburg/Saar, Germany;13. Leeds Teaching Hospitals NHS Trust and NHS Blood and Transplant;14. Department of Obstetrics Leeds General Infirmary, Leeds, UK |
| Abstract: | In Paroxysmal nocturnal haemoglobinuria (PNH), pregnancy is associated with increased maternal and foetal complications to such an extent that the condition has been considered relatively contra‐indicated in PNH. Eculizumab has revolutionized the treatment of PNH. We evaluate its use in pregnancy to date. We report on seven patients exposed to eculizumab at different stages of pregnancy including the first two patients to receive the drug from conception to delivery. There was no evidence of complement blockade from cord blood samples taken at delivery. Eculizumab appears safe to use in this setting and is likely to prevent many of the complications usually observed. |
| Keywords: | Paroxysmal Nocturnal Haemoglobinuria (PNH) pregnancy eculizumab |